PROVIDENCE-PROVIDENCE PARK HOSPITAL NPI 1376508333

NPI Information

NPI: 1376508333
Provider Name: PROVIDENCE-PROVIDENCE PARK HOSPITAL

Other Name: PH PHYSICIANS ASSISTANTS/PROVIDENCE HOSPITAL AND MEDICAL CENTERS INC

Classification: Physician Assistant - 363AM0700X
Entity Type: Organization

Specialization: Medical

Address:
16001 W 9 MILE RD
SOUTHFIELD, MI
ZIP 48075
Phone: (248) 849-3000
Get Directions

PROVIDENCE-PROVIDENCE PARK HOSPITAL is a medical physician assistant in Southfield, MI. PROVIDENCE-PROVIDENCE PARK HOSPITAL NPI is 1376508333. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Other Name Is Ph Physicians Assistants/providence Hospital And Medical Centers Inc.

The provider's business location address is:

16001 W 9 MILE RD
SOUTHFIELD, MI
ZIP 48075-818
Phone: (248) 849-3000
Fax: (248) 849-2244

The provider's authorized official is Jennifer Johnson .
The authorized official title is Director, Central Billing Office and has the following contact phone number (248) 680-8206.

The enumeration date for this NPI number is 4/20/2006 and was last updated on 8/25/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AS0400X	Physician Assistant	Surgical			No
2	363AM0700X	Physician Assistant	Medical			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0N89760	OTHER	MICHIGAN	MEDICARE GROUP PIN #

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »